| Linq Care Medical Provider, Llc. | |
|
525 Route 73 N Ste 104 Marlton NJ 08053-3422 | |
| (800) 525-9202 | |
| (630) 882-0553 |
| Full Name | Linq Care Medical Provider, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 525 Route 73 N Ste 104, Marlton, New Jersey |
| Authorized Official Name and Position | Richard Davis (CEO) |
| Authorized Official Contact | 3129614490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Linq Care Medical Provider, Llc. 50 S Main St Ste 200 Naperville IL 60540-5485 Ph: (770) 490-9634 | Linq Care Medical Provider, Llc. 525 Route 73 N Ste 104 Marlton NJ 08053-3422 Ph: (800) 525-9202 |
| NPI Number | 1427795509 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Medicare PECOS PAC ID | 4789055443 |
|---|---|
| Medicare Enrollment ID | O20230117003150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427795509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Karina Raupp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700201795 PECOS PAC ID: 5597034405 Enrollment ID: I20170710001274 |
| Provider Name | Sheena Gaddis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235452772 PECOS PAC ID: 4385071679 Enrollment ID: I20221214002839 |
| Provider Name | Irene Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679230163 PECOS PAC ID: 0042681702 Enrollment ID: I20230117003158 |
| Provider Name | Jennifer Mckinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649668112 PECOS PAC ID: 7618351685 Enrollment ID: I20230117003162 |
| Provider Name | Rachel Kujat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982376844 PECOS PAC ID: 0446635536 Enrollment ID: I20230117003165 |
| Provider Name | Amy L Tatham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447896725 PECOS PAC ID: 3072985548 Enrollment ID: I20230209000825 |
| Provider Name | Allison B Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962741827 PECOS PAC ID: 6002051265 Enrollment ID: I20230228002030 |
| Provider Name | Patricia Gloria Greenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164646634 PECOS PAC ID: 4981069614 Enrollment ID: I20230502000185 |
| Provider Name | Natalie Grace Montaldi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629403464 PECOS PAC ID: 7517300379 Enrollment ID: I20240208001637 |
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